Migraine and Vascular
Special Interest Section

Co-Chair: Huma Sheikh, MD
Co-Chair: Paul B. Rizzoli, MD, FAHS, FAAN

Stroke is one of the top causes of death and disability in the United States and migraine affects over a tenth of the population. [1] These are both high-frequency conditions that have a large impact on the public health. Migraine and stroke both involve an intimate connection between neuronal activity and blood vessels. However, the exact interplay still leaves a lot of room for elucidation.

A growing body of research indicates that the two are inter-related, with the most important recent finding being the increased risk of ischemic stroke among people with migraine with aura. [2] Although the link with stroke is strong, there is less confidence about the relationship between migraine and other cardiovascular outcomes. [3] Many of the studies that examine the risk between migraine and cerebrovascular diseases are under-powered or based on case studies. Prior studies have also been heterogeneous, which has implications for the quality of meta-analyses.

Exploring these areas would lead to important clinical implications. Currently, it is not routine to ask patients about their migraine history in the work up of a stroke. If it is determined that migraine is an independent risk factor, it will change how aggressively it is treated. This is a developing and quickly expanding field that can ultimately have a great impact on patients. With the recent increased interest, it may be hard to sort through all the information, which can be confusing for not only headache experts but primary care doctors as well.

For these reasons, we feel that a special interest section that explores the relationship between vascular pathology and migraine would be a valuable addition to the list of AHS special interest sections. The connection between headache and stroke needs to be better elucidated, which will in turn lead to better understanding of the pathophysiology of both diseases. [4] Although much of the interest is focused on stroke and migraine, there are also a number of other cerebrovascular diseases that interact with migraine, including RCVS and carotid dissection. This is an important developing field where information is expanding quickly and a forum to bring up-to-date, accurately interpreted information to practitioners is needed. It would be an a valuable addition to the AHS in making others aware of important new changes in this expanding sub-field of headache medicine.

Stroke is one of the top causes of death and disability in the United States and migraine affects over a tenth of the population. [1] These are both high-frequency conditions that have a large impact on the public health. Migraine and stroke both involve an intimate connection between neuronal activity and blood vessels. However, the exact interplay still leaves a lot of room for elucidation.

A growing body of research indicates that the two are inter-related, with the most important recent finding being the increased risk of ischemic stroke among people with migraine with aura. [2] Although the link with stroke is strong, there is less confidence about the relationship between migraine and other cardiovascular outcomes. [3] Many of the studies that examine the risk between migraine and cerebrovascular diseases are under-powered or based on case studies. Prior studies have also been heterogeneous, which has implications for the quality of meta-analyses.

Exploring these areas would lead to important clinical implications. Currently, it is not routine to ask patients about their migraine history in the work up of a stroke. If it is determined that migraine is an independent risk factor, it will change how aggressively it is treated. This is a developing and quickly expanding field that can ultimately have a great impact on patients. With the recent increased interest, it may be hard to sort through all the information, which can be confusing for not only headache experts but primary care doctors as well.

For these reasons, we feel that a special interest section that explores the relationship between vascular pathology and migraine would be a valuable addition to the list of AHS special interest sections. The connection between headache and stroke needs to be better elucidated, which will in turn lead to better understanding of the pathophysiology of both diseases. [4] Although much of the interest is focused on stroke and migraine, there are also a number of other cerebrovascular diseases that interact with migraine, including RCVS and carotid dissection. This is an important developing field where information is expanding quickly and a forum to bring up-to-date, accurately interpreted information to practitioners is needed. It would be an a valuable addition to the AHS in making others aware of important new changes in this expanding sub-field of headache medicine.

References

Goals & Objectives